First year mortality and hospital morbidity after newborn intensive care
Harding, J.E.; Howie, R.N.
New Zealand Medical Journal 100(831): 548-552
1987
ISSN/ISBN: 0028-8446 PMID: 3451137 Document Number: 304455
Researchers followed 4678 infants including 1113 admitted to the neonatal intensive care unit (NICU) born at the National Women's Hospital in 1980 in Auckland, New Zealand to determine subsequent mortality and hospital morbidity during the 1st year, 8.3% of infants born at this hospital and 7.2% of infants born at this hospital and not admitted to the NICU had been hospitalized at least once compared to 9.6% for all infants born in Auckland in 1980 (p.05 and p.001 respectively). An increased risk of subsequent hospitalization existed for infants who went to the NICU (11.7%; p.001), especially those weighing =or- 1500 g [VLBW] (15.5%; p.05). 30% of NICU infants had 1 subsequent hospitalization compared to 21.4% of all infants (p.05). Children born at this hospital and who had subsequent hospitalization averaged a 6.7 day hospitalization compared to 11 days for infants weighed 1501-2500 g (LBW) and 21.7 days for VLBW infants (both, p.001). Infections were the major reason for admissions for all groups, particularly for--VLBW infants (89.8%). The number of admission days for respiratory infections was substantially higher for NICU survivors than those not admitted to the NICU (621.7 vs. 114.4%; p.01). In addition, admission days for spina bifida/hydrocephalus for NICU survivors were significantly greater than those not admitted to the NICU (89.9 vs. 1.4; p.001). Nevertheless the median days/admission was similar for all birth weight groups. Physicians recorded feeding problems and apnea in all groups, and failure to thrive in all but the VLBW group. No NICU survivor had development delay or abnormal tone. The overall 1st year mortality rate was 5. None of the VLBW infants discharged from the NICU died during the 1st year. The highest 1st year mortality rate was for LBWs (8.6). Sudden infant death syndrome (SIDS) was responsible for 48% of all deaths. None of the NICU survivors died of SIDS. Congenital abnormalities were responsible for all deaths of NICU survivors 2500 g and 67% of all NICU survivors.